Clinical efficacy of endoscopic endonasal dorsum sellae and posterior clinoid process resection combined with pituitary hemi-transposition for pan-sellar area lesions
10.12025/j.issn.1008-6358.2026.20251659
- VernacularTitle:内镜经鼻鞍背后床突切除联合垂体侧方移位技术治疗泛鞍区疾病的临床效果分析
- Author:
Tabengwa GEORGE TAKURA
1
;
Qiang XIE
1
;
Huaichao ZHANG
1
;
Shuang LIU
1
;
Jinlong HUANG
1
;
Pin CHEN
1
;
Zeyang LI
1
;
Xiaobiao ZHANG
1
;
Tao XIE
1
Author Information
1. Department of Neurosurgery, Zhongshan Hospital, Fudan University, Shanghai 212001, China.
- Publication Type:Techniqueandmethod
- Keywords:
pan-sellar region lesions;
endoscopic endonasal approach;
posterior clinoid process;
pituitary transposition
- From:
Chinese Journal of Clinical Medicine
2026;33(3):507-515
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical efficacy and safety of endoscopic endonasal dorsum sellae and posterior clinoid process resection combined with pituitary hemi-transposition in the treatment of pan-sellar area lesions. Methods Clinical data from 57 patients with pan sellar diseases who underwent endoscopic transnasal resection of the posterior clinoid process combined with lateral pituitary displacement surgery in the neurosurgery department of Zhongshan Hospital, Fudan University from January 2019 to January 2025 were collected, and their clinical surgical characteristics and prognosis were analyed. Results A total of 57 patients with pan-sellar area lesions were included in this study, comprising 27 craniopharyngiomas, 7 giant suprasellar pituitary adenomas, 7 chordomas, 6 chondrosarcomas, 5 diaphragma sellae/dorsum sellae meningiomas, and 5 rare lesions. All procedures were completed successfully, and gross total or near-total resection was achieved in all patients. No new neurovascular complications occurred intraoperatively. The follow-up duration ranged from 3 to 24 months. New postoperative anterior pituitary insufficiency occurred in 3 patients (5.3%), and new posterior pituitary insufficiency requiring long-term hormone replacement therapy occurred in 4 patients (7.0%). No additional pituitary dysfunction was observed in the remaining patients. Cerebrospinal fluid rhinorrhea occurred in 1 patient (1.8%) and was successfully repaired. Intracranial infection occurred in 3 patients (5.3%) and resolved after medical treatment. Conclusion Endoscopic resection of the posterior clinoid process combined with lateral displacement of the pituitary gland can effectively expand the surgical space, while repositioning the pituitary gland can reduce the extent of skull base defects. In addition, the risk of pituitary dysfunction caused by lateral displacement of the pituitary gland is relatively low.
